The international community must treat the deadly Israeli strike that killed seven humanitarian workers in Gaza as a watershed moment, aid groups say, accusing Israel of "systematic" attacks on civilians and NGOs working there.
Charities told news agency AFP they had no immediate plans to pull out of Gaza after an Israeli air strike killed seven staff of the US-based food charity World Central Kitchen (WCK).
But they said conditions were becoming increasingly impossible, pointing to serious problems with a coordination system that is aimed at keeping aid workers safe from Israeli strikes.
The United Nations says the bloodiest-ever Gaza war has left nearly 200 aid workers dead, including more than 175 members of the UN's staff.
The WCK stressed that its staff had come under attack "despite coordinating movements" with the Israeli army and travelling in a de-conflicted zone in two armoured cars branded with the WCK logo and another vehicle.
"Israel has now killed more aid workers in Gaza than all other armies, militias and terrorists in all other wars combined," said Jan Egeland who heads the Norwegian Refugee Council.
"I deeply hope that this terrible attack will act as some kind of watershed moment, and lead to a change in approach," he said, reiterating calls for a sustained ceasefire.
Bushra Khalidi, Oxfam's policy adviser for the Palestinian territories, said staff have been "terrified" and tried to minimise their movements.
"There's been a deliberate and systematic assault on humanitarian aid efforts, including humanitarian aid workers," she said. "We've seen a systematic disregard for the de-confliction system."
Benjamin Gaudin, who leads the Middle East operations of Premiere Urgence Internationale, a France-based NGO, said his organisation had no immediate plans to pull out even though it was "very difficult" to continue to work in Gaza.
"This attack is catastrophic not only for the World Central Kitchen, but also for the entire humanitarian community," said Gaudin.
Like other relief groups, Gaudin's NGO has been seeking to closely coordinate their movements with Israel through a special "platform" but pointed to communications problems.
"So far it hasn't guaranteed the safety of the organisations, because many incidents have occurred despite this system being put in place," he said.
Egeland said the notification and coordination system with the Israeli army was "in deep crisis" and had to be rebooted.
The deadly attack "either shows that Israel has no control over its forces - that indiscriminately attack in Gaza -- or that it has never communicated with its armed operations the notifications that it had promised to communicate," he said. "Both would be unforgivable."
Camilla Dogliotti of Handicap International whose office in Gaza City was destroyed in a bombing strike in late January said "the level of risk is very high in some southern and central areas of Gaza and unacceptable in all other areas."
"This new attack is first and foremost the consequence of Israel's continued disrespect of international humanitarian law and of the required protection of civilians, including aid workers, during conflict," she said.
Israeli Prime Minister Benjamin Netanyahu said the military had "unintentionally" killed the aid workers, calling it a "tragic case" that would be investigated "right to the end".
The war erupted after Palestinian group Hamas's October 7 attack on Israel, which resulted in about 1,160 deaths in Israel, according to Israeli official figures.
Palestinian fighters also seized around 250 hostages. Israel believes about 130 remain in Gaza, including 34 presumed dead.
Israel's relentless campaign has killed at least 32,975 people in Gaza, mostly women and children, according to the health ministry in the besieged Palestinian territory.
Gaza is under a near-complete blockade, with the United Nations accusing Israel of preventing deliveries of humanitarian assistance to its population of 2.4 million.
France-based Doctors Without Borders (MSF) has lost five Palestinian staff since the start of the war. They were killed either in Israeli bombardments or shot at point-blank range close by an Israeli roadblock, according to the group.
"The level of danger we are facing in Gaza is unprecedented in the history of MSF," said spokeswoman Claire Magone.
Caroline Seguin, deputy program manager for Middle East at MSF, believes Israeli authorities are targeting hospitals intentionally and also restricting their ability to deploy equipment.
"There are now only 10 or so hospitals operating in the Gaza Strip, whereas there used to be 36," Seguin said. "There's a lot of equipment that we're trying to get in, but the Israelis are systematically rejecting it, particularly desalination plants so that we can give people plenty of water."
"I don't know how we're going to carry on working," she added. "We will continue, for as long as we can."